Pterygium: How Sun Exposure Fuels Eye Growth and What Surgery Can Do

Pterygium isn’t just a cosmetic issue-it’s a slow-moving threat to your vision if left unchecked. Often called "Surfer’s Eye," this fleshy, triangular growth starts on the white of your eye and creeps toward the pupil. It doesn’t spread like cancer, but it can blur your sight, make contact lenses unbearable, and leave your eye red and irritated for months. And the biggest culprit? The sun. Not just a sunny day at the beach-every hour spent outdoors without proper eye protection adds up. If you live near the equator, work outside, or spend time on water or snow, you’re at higher risk. The good news? You can stop it in its tracks-or fix it safely if it’s already growing.

What Exactly Is a Pterygium?

A pterygium is a growth of the conjunctiva, the thin, clear membrane covering the white part of your eye. It begins near the nose, where UV rays hit hardest, and stretches like a wing toward the center of your eye. When it reaches the cornea-the clear front surface-you start seeing problems. At first, it might look like a small pink patch with visible blood vessels. Later, it can become thick, opaque, and cover part of your pupil. That’s when your vision gets blurry, especially if it distorts the shape of your cornea and causes astigmatism.

It’s not rare. About 12% of Australian men over 60 have it. In tropical areas like northern Queensland or Central America, rates climb to 20% or higher. Around 60% of people with pterygium have it in both eyes. It’s more common in men, likely because they spend more time outdoors in jobs like fishing, farming, or construction. The growth doesn’t hurt, but it can feel gritty, dry, or like there’s sand in your eye. Many people ignore it until it starts affecting how clearly they see.

Why the Sun Is the Main Cause

Ultraviolet (UV) radiation is the #1 trigger. Studies show that people living within 30 degrees of the equator have more than double the risk of developing pterygium compared to those farther north or south. Cumulative UV exposure over 15,000 joules per square meter increases your risk by 78%. That’s roughly 10 years of daily outdoor exposure without protection.

It’s not just beach days. UV rays reflect off water, sand, and snow-so surfers, fishermen, skiers, and even gardeners are at risk. In Wellington, New Zealand, where the ozone layer is thinner and UV levels stay high year-round, outdoor workers face the same danger as those in tropical zones. The sun doesn’t need to be blazing hot to damage your eyes. UV exposure happens even on cloudy days.

Unlike pinguecula-a yellowish bump on the conjunctiva that stays on the white of the eye-pterygium crosses the line onto the cornea. That’s what makes it vision-threatening. If you’ve had a pinguecula for years and it starts growing toward your pupil, it’s no longer just a bump. It’s a pterygium.

How Fast Does It Grow?

There’s no set timeline. Some pterygia stay small for decades. Others grow 0.5 to 2 millimeters per year under constant sun exposure. A growth that was barely noticeable in your 30s might block your vision by your 50s. The rate depends on how much UV you’ve absorbed, your genetics, and whether you wear eye protection.

Doctors use a slit-lamp-a special microscope with 10 to 40x magnification-to track growth. They measure the width at the base and how far it’s moved toward the pupil. No blood tests or scans are needed. If your eye doctor sees tissue creeping onto the cornea, it’s pterygium. Early detection is key. Once it reaches the center of your pupil, your vision changes become harder to reverse.

When Is Surgery Necessary?

Most pterygia don’t need surgery. If it’s small, not growing, and doesn’t bother you, your doctor will likely recommend eye drops and sun protection. But surgery becomes the next step if:

• Your vision is blurry because the growth is near or over your pupil
• You can’t wear contact lenses because of irritation
• The pterygium is cosmetically disturbing and affects your confidence
• It keeps coming back after previous removal

The most common surgery is called a conjunctival autograft. The surgeon removes the pterygium and replaces it with a small piece of healthy conjunctiva taken from another part of your eye-usually under your upper eyelid. This reduces the chance of it growing back. In some cases, doctors use a thin amniotic membrane from donated tissue, which helps the eye heal faster and reduces inflammation.

To cut recurrence rates even further, many surgeons apply a drug called mitomycin C during surgery. It’s a mild chemotherapy agent that stops abnormal cells from regrowing. With mitomycin C, recurrence drops from 30-40% to just 5-10%. Without it, you’re looking at nearly half the time that the pterygium returns.

What to Expect After Surgery

The procedure takes about 30 to 45 minutes and is done under local anesthesia. You’re awake but feel no pain. Most people go home the same day.

Recovery isn’t quick. For the first week, your eye will be red, swollen, and sensitive to light. You’ll need to use steroid eye drops for 4 to 6 weeks to prevent inflammation and scarring. Some patients say the drops are harder to stick with than the surgery itself. You’ll also need to avoid swimming, dusty environments, and direct sun for at least a month.

About 78% of patients report a quick recovery and improved vision. But 42% say discomfort lasts 2-3 weeks, and 37% are unhappy with how red their eye looks during healing. It’s normal, but it can be unsettling. That’s why follow-up visits are critical-your doctor needs to check for signs of infection or early regrowth.

How to Prevent It (Or Stop It From Getting Worse)

Prevention is cheaper, easier, and far less stressful than surgery. Here’s what actually works:

• Wear UV-blocking sunglasses every day, even when it’s cloudy. Look for labels that say "100% UV protection" or "UV400." ANSI Z80.3-2020 standards ensure they block 99-100% of UVA and UVB rays.
• Pair sunglasses with a wide-brimmed hat. This cuts UV exposure to your eyes by up to 50%.
• Don’t wait until you’re older to start protecting your eyes. Damage adds up over time.
• If you’re near water, snow, or sand, use wraparound sunglasses. These block UV from the sides.
• Check the UV index daily. When it hits 3 or higher, your eyes need protection. In many parts of New Zealand, that’s true 200+ days a year.

One Reddit user, "OutdoorPhotog," shared that after 10 years of wearing UV-blocking sunglasses daily, his pterygium stopped growing entirely. His doctor confirmed it during his annual check-up. That’s the power of prevention.

What’s New in Treatment?

In 2023, the FDA approved a new eye drop called OcuGel Plus, made by Bausch + Lomb. It’s preservative-free and designed specifically for post-surgery patients. In trials, it gave 32% more relief from dryness and irritation than standard artificial tears.

In Europe, amniotic membrane transplants are now recommended as the first choice for recurrent pterygium. A 15-country study showed a 92% success rate in stopping regrowth.

The most exciting development? Topical rapamycin. It’s a drug that blocks the cells responsible for pterygium growth. In Phase II trials, it cut recurrence by 67% compared to placebo. It’s not available yet, but if approved, it could change how we treat pterygium-maybe even replace surgery for some patients.

Why Some People Keep Getting It Back

Recurrence is the biggest frustration. Even with surgery, up to 40% of cases grow back if no adjunctive treatment is used. The main reasons:

• No mitomycin C or amniotic membrane used during surgery
• Not wearing sunglasses after surgery
• Returning to high UV environments too soon
• Genetic predisposition (some families have higher rates)

A 2022 survey by the National Eye Institute found that 32% of surgical patients had regrowth within 18 months. That’s why follow-up care matters as much as the surgery itself. If you’ve had it removed once, you’re at higher risk of it coming back. Stay vigilant.

Who’s Most at Risk?

- Men over 40: 3 in 5 cases are male, likely due to outdoor work patterns. - People living within 30 degrees of the equator: Australia, Brazil, India, Kenya, and Indonesia have the highest rates. - Outdoor workers: Farmers, fishermen, construction crews, and lifeguards. - Those with a family history: Studies show a 40% higher risk if a parent or sibling had it. - People in high-altitude or reflective environments: Snow, sand, and water amplify UV exposure.

Australia has the highest national prevalence-23% of adults over 40. That’s why public health campaigns there focus heavily on UV eye protection in schools and workplaces.

What’s the Cost?

Conservative care (eye drops, sunglasses) costs less than $100 a year. Surgery varies by country. In the U.S., it ranges from $2,000 to $5,000 per eye. In Australia and New Zealand, it’s often covered by public health systems if vision is affected. Private clinics may charge more for advanced techniques like amniotic grafts.

The global pterygium treatment market is worth $1.27 billion and growing. That’s because demand is rising-not just from aging populations, but from climate change. As the ozone layer weakens, UV exposure increases, especially in mid-latitude regions like New Zealand and southern Australia.

Final Takeaway

Pterygium isn’t an emergency, but it’s not harmless either. It’s a warning sign that your eyes have had too much sun. If you’re noticing a pink, growing patch on your eye, don’t wait. See an eye doctor. Get a slit-lamp exam. Start wearing proper sunglasses now-even if you think you’re fine.

If surgery is needed, know your options. Ask about mitomycin C or amniotic membrane grafts to lower your risk of recurrence. And no matter what, protect your eyes every single day. The sun doesn’t care if you’re inside, driving, or on a cloudy day. It’s still there. And so is the risk.